Evidence-Based Nutrient Recommendations

Vitamin-B12 Fortified Toothpaste

We updated our Vitamin B12: Vegan Sources page with two intervention studies using vitamin B12-fortified toothpaste.

B12 Toothpaste in Vegans

A 2017 randomized, double-blind, placebo-controlled trial was the first to test the efficacy of vitamin B12-fortified toothpaste in raising blood markers of vitamin B12 status (1). The trial was conducted in Germany and included 66 vegans. 22 participants in the placebo group and 31 in the intervention group were taking B12 supplements; they were asked to continue their supplementation behavior throughout the study).

Participants were instructed to use the study-issued toothpaste twice a day, brushing for two minutes each time. The treatment toothpaste contained 100 mcg B12/g toothpaste. Researchers estimated participants received 130-290 mcg B12 per day via the toothpaste, but were not able to calculate or measure how much B12 the participants absorbed.

At the end of 12 weeks, compared to their baseline values, participants in the intervention group experienced significantly increased B12 (from 197±137 to 279±134 pmol/L; p=0.001) and holotranscobalamin (from 35±35 to 64±34 pmol/L; p<0.001), significantly decreased methylmalonic acid (MMA) (from 0.303±0.361 to 0.212±0.123 µmol/L; p=0.001), and not-quite-significantly decreased total homocysteine (from 10.6±6.2 to 9.7±6.4 µmol/L; p=0.058). These changes are associated with improved B12 status.

Changes were greater in those reporting not taking B12 supplements. Participants in the placebo group did not experience significant changes in their B12 markers between baseline and the end of the intervention.

Based on this study, it appears that B12-fortified toothpaste may serve as a viable source of vitamin B12 for vegans.

B12 Toothpaste in Older Adults

A 2019 randomized, double-blind, placebo-controlled trial assessed the efficacy of vitamin B12-fortified toothpaste in a sample of 92 older adults (2). After 3 months, those receiving the treatment toothpaste (100 mcg B12/g toothpaste) experienced significantly greater B12 levels (368 vs. 295 pmol/L; p = 0.005) compared with the placebo group. Researchers concluded that B12-fortified toothpaste may be used to help prevent vitamin B12 depletion in older people.


1. Siebert AK, Obeid R, Weder S, Awwad HM, Sputtek A, Geisel J, Keller M. Vitamin B-12-fortified toothpaste improves vitamin status in vegans: a 12-wk randomized placebo-controlled study. Am J Clin Nutr. 2017 Mar;105(3):618-625. doi: 10.3945/ajcn.116.141978. Epub 2017 Jan 4.

2. Zant A, Awwad HM, Geisel J, Keller M, Obeid R. Vitamin B12-fortified toothpaste improves vitamin status in elderly people: a randomized, double-blind, placebo-controlled study. Aging Clin Exp Res. 2019 Dec;31(12):1817-1825. doi: 10.1007/s40520-019-01125-6. Epub 2019 Jan 24.

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